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Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors

Nature Reviews Gastroenterology & Hepatology volume 18, pages 493–502 (2021)Cite this article

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Abstract

Pancreatic cancer is a leading cause of cancer death worldwide and its global burden has more than doubled over the past 25 years. The highest incidence regions for pancreatic cancer include North America, Europe and Australia, and although much of this increase is due to ageing worldwide populations, there are key modifiable risk factors for pancreatic cancer such as cigarette smoking, obesity, diabetes and alcohol intake. The prevalence of these risk factors is increasing in many global regions, resulting in increasing age-adjusted incidence rates for pancreatic cancer, but the relative contribution from these risk factors varies globally due to variation in the underlying prevalence and prevention strategies. Inherited genetic factors, although not directly modifiable, are an important component of pancreatic cancer risk, and include pathogenic variants in hereditary cancer genes, genes associated with hereditary pancreatitis, as well as common variants identified in genome-wide association studies. Identification of the genetic changes that underlie pancreatic cancer not only provides insight into the aetiology of this cancer but also provides an opportunity to guide early detection strategies. The goal of this Review is to provide an up-to-date overview of the established modifiable and inherited risk factors for pancreatic cancer.

Key points

  • Smoking continues to be a leading cause of pancreatic cancer worldwide.

  • Increasing rates of diabetes and obesity will probably result in increased rates of pancreatic cancer.

  • Growing evidence indicates that high alcohol intake contributes to pancreatic cancer risk.

  • Knowledge of inherited genetic factors in pancreatic cancer continues to grow and probably explains 22–33% of pancreatic cancer risk.

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Fig. 1: Incidence of pancreatic cancer.

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Acknowledgements

The work of the author is supported by NCI RO1CA154823, U01CA247283, NCI P50 CA62924 and P30CA006973, and the Sol Goldman Pancreatic Cancer Research Center.

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  1. Sidney Kimmel Comprehensive Cancer Center, Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Alison P. Klein

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National Cancer Institute. SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program: https://seer.cancer.gov/explorer/

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Klein, A.P. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol 18, 493–502 (2021). https://doi.org/10.1038/s41575-021-00457-x

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